Hassan, Suzan Alev;
(2021)
Exploring factors that contribute to health behaviours in people with severe mental illness to reduce cardiovascular disease risk: a mixed-methods approach.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
Background: Unhealthy behaviours may contribute to the increased risk of cardiovascular disease in people with severe mental illness (SMI). Much is still unknown on how to overcome such challenges, particularly across healthcare contexts. Objectives: To explore in people with SMI: • Literature on factors associated with physical activity (PA) and diet related longitudinal outcomes. • Associations between baseline sociodemographic, health, social, wellbeing, quality of life, behavioural factors and PA/dietary-related changes over 12-months. • Staff and patient perspectives on how health behaviours may be supported and changed within a primary care-led intervention and integrated healthcare context. Methods: 1) Systematic review, 2) secondary longitudinal analyses, 3) secondary qualitative thematic analysis and 4) primary qualitative study and thematic analysis. Results: 1) Few studies have explored associations between baseline factors and PA/dietary-related outcomes. 2) Few factors were associated with PA or dietary-related changes. Higher alcohol intake was associated with worsening PA levels. 3) Various behaviour change techniques (BCTs) were reported in the primary care intervention. Visible benefits of healthy behaviours, health knowledge/perceptions, mental health symptoms, social networks, physical environment, access to time/resource, and staff skills affected supporting/changing health behaviours. 4) BCTs were variably reported in the integrated healthcare context but shaping knowledge, social support, natural consequences, and biofeedback were more consistently reported. The consistency of health information provided by staff, patient self-awareness of consequences of behaviours, habitual behaviours, financial, environmental circumstances, social networks, staff support, staff behaviour change knowledge, staff time availability, staff role perceptions, capitalising on specialist staff knowledge/skills influenced supporting/changing behaviours. Conclusions: There are few established factors predictive of health behaviour change in people with SMI. Primary care and mental health professionals could work together using complementary skills to engage patients and support healthy behaviours, but organisations may need to support this way of working. Flexible strategies targeting patients’ individual needs could be adopted.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Exploring factors that contribute to health behaviours in people with severe mental illness to reduce cardiovascular disease risk: a mixed-methods approach |
| Event: | UCL (University College London) |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author [year]. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10126202 |
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